MEDICARE: MRS. CRISTINA MANTILLA MA, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MI10384	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215240536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CRISTINA MANTILLA MA, LMHC

Provider Business Mailing Address
First Line	:	9400 RIVER CROSSING BLVD STE 101
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-6033
Country	:	US
Telephone Number	:	727-505-6379
Fax Number	:	866-926-7270

Provider Business Practice Location Address
First Line	:	9400 RIVER CROSSING BLVD STE 101
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-6033
Country	:	US
Telephone Number	:	727-967-7494
Fax Number	:	866-926-7270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2010
Last Update Date	:	11/24/2025

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